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The Role of Biliary Bacteriology and Administration of Antibiotics

Michael B. Farnell, MD; Jonathan A. van Heerden, MB, FRCS(C); Robert W. Beart, Jr, MD

Arch Surg. 1981;116(5):537-540.

Abstract
• One hundred patients who underwent elective cholecystectomy were studied prospectively to define the accuracy of an intraoperative Gram's stain procedure in discovering the presence of bactibilia, the apparent necessity for prophylactic use of antibiotics, and the resulting septic complication rate. Antibiotics were used for prophylaxis in 48 patients and were withheld from 52. Intraoperative Gram's stain procedure and culture were used in all cases. Bactibilia was present in 23% of the group and was accurately predicted by Gram's stain in 87% of all. The only septic complication was a stitch abscess in one patient in the group that received antibiotics. The presence of bactibilia does not seem to be associated with an increased incidence of infectious complications in elective cholecystectomy for chronic cholecystitis. Routine use of Gram's stain should detect the presence of Gram-positive rods (Clostridium), thus allowing early initiation of appropriate treatment.

(Arch Surg 1981;116:537-540)

Author Affiliations
From the Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication Dec 19, 1980.

Read before the 88th annual meeting of the Western Surgical Association, Salt Lake City, Nov 17, 1980.

Reprint requests to Section of Publications, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Farnell).

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Septicemia From Biliary Tract Infection
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Arch Surg 1988;123:366-368.
ABSTRACT